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Biomedical subjects

J M Lane

Publications and source records attributed to J M Lane.

At least 109 records · Page 6Linked to original sources
PubMed1990

Paget's disease of bone.

Paget's disease of bone is defined as a process of increased bone remodeling; the primary event is increased resorption (osteoclastic activity) followed by subsequent reactive bone formation (osteoblastic activity). It is usually asymmetric and may be asymptomatic. The etiology is unknown, but recent evidence appears to support the theory that a virus is an important etiologic factor. It may present with a wide variation in the clinical and radiographic picture. The most frequent sites of involvement include the spine, femora, cranium, pelvis, and sternum. The most common complaints are pain, skeletal deformity, and change in skin temperature. Pathologic fractures may be the presenting manifestations or complications in a patient with known Paget's disease. They occur most frequently in the long weight-bearing bones of the lower extremities such as the femoral neck and subtrochanteric and tibial regions. The two major therapeutic agents available for treatment are calcitonins (porcine, salmon, or human) and diphosphonates. The aim of such therapy is to control the metabolic activity of the disease, to normalize the biochemical parameters, and to improve the symptoms. Fortunately, tumors are rare; early diagnosis may give rise to more effective palliation, if not a significant cure rate.

Humans↗
PubMed1990

New advances and concepts in amputee management after treatment for bone and soft-tissue sarcomas.

Amputation is still necessary to achieve disease-free margins in some patients with osteogenic sarcoma. Improving the quality of life for this largely young patient population has become increasingly important considering the dramatic increase in their survival rate. A multidisciplinary approach should include prosthetic devices that are comfortable and lightweight, and produce an energy-efficient gait, an aggressive postoperative rehabilitation, and an objective evaluation of progress. This approach will help improve the high net energy expenditure of ambulation and the asymmetrical stance time experienced by this group of individuals and allow them to gain equal status in society.

Amputation, Surgical↗
PubMed1990

The Van Nes tibial rotationplasty. A functionally viable reconstructive procedure in children who have a tumor of the distal end of the femur.

Twelve patients who had a malignant tumor of the distal end of the femur were treated with a Van Nes tibial rotationplasty. The survival rates were comparable with those for above-the-knee amputees and patients who had an endoprosthetic replacement. The results of functional testing showed that these patients performed as well as those who had endoprosthetic replacement and better than those who had above-the-knee amputation. Rotationplasty is therefore a favorable alternative to amputation or endoprosthetic replacement, either as a primary or as a salvage procedure.

Adolescent↗
PubMed1990

Treatment of pathologic fractures of the distal femur with the Zickel supracondylar nail.

Thirteen patients with 14 pathologic, supracondylar, and distal femoral fractures were evaluated retrospectively. The Zickel supracondylar device was easy to use and applicable to a wide range of clinical problems. It provided good functional and symptomatic results in 11 of 14 cases. Two patients required a removal of metal implants due to soft-tissue irritation. Attention to the detail of insertion of the Zickel device may prevent complications.

Adult↗
PubMed1990

Percutaneous bone marrow grafting of delayed union and nonunion in cancer patients.

Bone marrow is a source of osteoprogenitor cells that are key elements in the process of bone formation and fracture healing. Eight patients with primary sarcomas treated by extensive en bloc resections and reconstruction using internal fixation who developed delayed unions or nonunions were treated by injection of autogeneic bone marrow into the site of failed healing. Five of the eight patients received chemotherapy, with one patient receiving radiation therapy in addition. Bone formation was noted in seven patients after injection. Union was achieved in five of the patients. These results, obtained in difficult clinical circumstances, are encouraging and suggest that autogeneic bone marrow grafting is a useful technique in the treatment of delayed unions and nonunions and warrant further clinical studies.

Adolescent↗
PubMed1990

Paget's disease of bone.

Paget's disease of bone is defined as a process of increased bone remodeling; the primary event is increased resorption (osteoclastic activity) followed by subsequent reactive bone formation (osteoblastic activity). It is usually asymmetric and may be asymptomatic. The etiology is unknown, but recent evidence appears to support the theory that a virus is an important etiologic factor. It may present with a wide variation in the clinical and radiographic picture. The most frequent sites of involvement include the spine, femora, cranium, pelvis, and sternum. The most common complaints are pain, skeletal deformity, and change in skin temperature. Pathologic fractures may be the presenting manifestations or complications in a patient with known Paget's disease. They occur most frequently in the long weight-bearing bones of the lower extremities such as the femoral neck and subtrochanteric and tibial regions. The two major therapeutic agents available for treatment are calcitonins (porcine, salmon, or human) and diphosphonates. The aim of such therapy is to control the metabolic activity of the disease, to normalize the biochemical parameters, and to improve the symptoms. Fortunately, tumors are rare; early diagnosis may give rise to more effective palliation, if not a significant cure rate.

Bone and Bones↗
PubMed1989

Omental angiogenic lipid fraction and bone repair. An experimental study in the rat.

A lipid material extracted from the omentum has previously been shown to contain a potent angiogenetic activator (20), capable of creating intense vasoproliferation in traumatized tissues (19). This study was undertaken to analyze the efficacy of local administration of this omental lipid fraction on osseous vascularization and bone repair. An osteoperiosteal segmental femoral defect in the rat was replaced by a demineralized allogenic bone graft exposed to continuous local delivery of omental lipid via an implanted miniosmotic pump. Saline solution delivered in the same way served as a control. Neovascularization and bone formation in the transplant were quantitatively evaluated by means of dynamic radioisotopic bone imaging, radiographic photodensitometry, microangiography, and biomechanical testing. Compared with the control group, the omental lipid angiogenic fraction-treated specimens showed an 80% overall increase (p less than 0.001) in bone density as well as a twofold increase (p less than 0.001) in regional blood perfusion, maximal at 2 weeks following surgery. At 12 weeks, biomechanical testing demonstrated significantly higher union rate (p less than 0.05) and strength (p less than 0.01) in the treated specimens as compared with the controls. These data demonstrate that the omental lipid fraction factor has potent angiogenic properties that enhance bone blood perfusion and bone regeneration.

Absorptiometry, Photon↗
PubMed1989

Subacute osteomyelitis presenting as bone tumors.

The problem of the differential diagnosis between subacute osteomyelitis and primary bone tumors is a difficult one. Presenting symptoms, duration of disease, laboratory data, and location of the pathologic process are of little assistance. The authors reviewed eight typical cases. Preoperative diagnosis included benign and malignant bone tumors, as well as osteomyelitis; but the final diagnosis of osteomyelitis was made only after open biopsy and culture. The presenting symptoms and signs included: pain, usually dull; soft tissue mass; and, rarely, low grade fever. The radiographic features were usually a lytic area with various degrees of sclerotic reaction. White blood count and sedimentation rate were not helpful. The treatment, including surgical curettage and appropriate antibiotic therapy, resulted in resolution of the process and healing of the bony defects.

Adolescent↗
PubMed1989

Chordoma: a critical review of diagnosis and treatment.

Chordomas have typical clinical, radiographic, and histologic presentations that must be understood by all orthopedists treating spinal or neoplastic disease. Improvements in imaging have enhanced early, accurate diagnosis and anatomic localization of tumors. Multimodality therapy with aggressive surgery and spinal cord-sparing radiation therapy can achieve good tumor control.

Bone Neoplasms↗
PubMed1989

[Resection of bony tumors around the knee and lengthening of the stump by the Van Nes rotation plastic surgery technic].

The Van Nes rotation plastic surgery technic is a procedure to lengthen the femoral stump. It is used for patients with an immature skeleton who present a malignant bone tumour around the knee. The operation is an alternative to high transfemoral amputation. Nine patients treated with this procedure are reviewed. In five surviving patients, characteristics of walking, extension strength of the foot, and early and late complications were satisfactory.

Adolescent↗
PubMed1989

Factors associated with the decline of the Cooperative Medical System and barefoot doctors in rural China.

The Cooperative Medical System (CMS) and its barefoot doctors have been in decline in rural China for nearly a decade. In order to explore the reasons for this, in 1987 we carried out a survey of villagers, barefoot doctors, and local administrators in Fengxian, Shanggoa, and Loaan counties, where incomes are good, fair, and low, respectively. The state of the CMS in these counties was contrasted and the situations which prevailed in 1978, 1982, and 1985, when the system was, respectively, at its peak, had begun to decline, and had declined markedly, were compared. A random sample of villages was selected and all the barefoot doctors and administrators as well as a random sample of households were surveyed. The results indicate that health status (as measured by infant mortality, immunization coverage, and rate of infectious diseases) has decreased in areas where the CMS has declined, while per capita incomes increased. Concomitantly, villager's expenditures on health care have increased. Barefoot doctors and their patients were, however, reasonably happy with the system, and in its absence the doctors are no longer able to obtain ongoing training. The CMS was fiscally sound, and did not decline to the same extent in all areas--it continues to thrive in Fengxian, which is relatively affluent. It is concluded that the system probably declined because many local administrators perceived that it no longer enjoyed the backing of the central government.

China↗
PubMed1988

Inhibition of CCl4 metabolism by oxygen varies between isoenzymes of cytochrome P-450.

Oxygen inhibition of CCl4 metabolism by different isoenzymes of cytochrome P-450 was assessed by studying liver microsomes isolated from control rats and rats treated with phenobarbital or isoniazid. Rates of CCl4 metabolism were similar for all microsomes under a nitrogen atmosphere. An air atmosphere inhibited metabolism by microsomes from control rats to 12% of the value under nitrogen and metabolism by microsomes from rats treated with phenobarbital to 5%. It inhibited metabolism by microsomes from rats treated with isoniazid only to 32%. Rats treated with phenobarbital, which increases hepatic cytochrome P-450 content, or isoniazid, which does not increase hepatic cytochrome P-450 content, both metabolized more CCl4 than control rats as indicated by exhalation of greater quantities of CCl4 metabolites and by an increase in CCl4 toxicity. These results indicate that some isoenzymes of cytochrome P-450 are more effective than others in metabolizing CCl4 when oxygen is present.

Animals↗
PubMed1988

Bone mineralization in women following successful treatment of Hodgkin's disease.

PURPOSE: Women with Hodgkin's disease in whom a cure has been achieved may be at risk for osteoporosis because of therapy-induced premature menopause. Our objective was to gather information regarding the integrity of bone mass in such long-term cancer survivors. SUBJECTS AND METHODS: Bone mineral density was measured using photon absorptiometry in five groups of women: 11 patients with Hodgkin's disease and ovarian failure (Group I); six patients with Hodgkin's disease and ovarian failure who received estrogen replacement (Group II); 15 patients with Hodgkin's disease and normal ovarian function (Group III); 16 premenopausal control subjects (Group IV); and 11 postmenopausal control subjects (Group V). All patients with Hodgkin's disease were in remission and had completed treatment more than five years earlier. RESULTS: Subjects in Group I were found to have significantly decreased radial (p = 0.0009), lumbar spine (p = 0.002), and femoral neck (p = 0.0001) bone mineral density measurements compared with those in subjects in Group IV; the bone mineral density measurements at all sites of subjects in Group I were no different than those of subjects in Group V. Subjects in Group III had bone density measurements that were similar to those in Group IV, although the radial bone mineral density value was significantly lower (p = 0.0004). Determination of serum gonadotropins and estradiol was consistent with the menstrual status defining the five groups. No secondary causes for decreased bone mineral density values could be detected, since the mean serum levels of parathyroid hormone, calcium, phosphorus, and vitamin D metabolites were similar among the groups, and all prolactin levels were normal. CONCLUSION: We have identified a new population of patients with a high risk of osteoporosis, and these results emphasize the importance of treatment-related ovarian failure in the pathogenesis of osteoporosis.

Adult↗
PubMed1988

Quantification of osteopenia in hip fracture patients.

Osteopenia was assessed in 56 consecutive hip fracture patients by using dual photon absorptiometry of the lumbar spine and uninjured, contralateral femoral neck and by performing iliac crest biopsy. Of the 56 patients, 47 were female and 9 were male. The mean age was 78 years. There were 31 femoral neck and 25 intertrochanteric fractures. Two comparison populations were also studied. Population 1 consisted of 269 postmenopausal females older than 60 years of age with no history of fracture who were referred for dual photon absorptiometry of the lumbar spine as screening for osteoporosis. Population 2 included 94 patients with vertebral compression fractures who underwent transilial biopsy to evaluate osteoporosis. All transilial biopsies were assessed with the use of quantitative histomorphometry. Dual photon absorptiometry of the lumbar spine indicated that 76.9% of the hip fracture patients had severe bone loss (less than 1 gm/cm2). Nevertheless, no difference in spinal bone density was found when the hip fracture patients were compared to population 1. No difference in density of the lumbar spine or femoral neck was found in patients in the hip fracture group when intertrochanteric and femoral neck fractures were compared. No difference in histomorphometric measurements of total bone, cortical bone, and cancellous bone volume was noted between the hip fracture patients and population 2. There was no difference noted when the intertrochanteric and femoral neck fracture patients were compared. No evidence of osteomalacia was noted in any group.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Osteoporosis.

Osteoporosis is a significant cause of morbidity and mortality in the elderly. As the population in the United States becomes more aged, the magnitude of this problem will certainly become greater. Significant progress has been made in recent years with regard to the diagnosis and treatment of osteoporotic bone disease. Future treatment possibilities being investigated include cyclical coherence programs and cyclical parathyroid hormone administration. While showing some initial promise, these new modalities have been used only in a limited number of patients and must be considered highly experimental. Despite the progress being made in the treatment of osteoporosis, hope for the future clearly rests with prevention. Arresting bone loss has proven to be much more effective than rebuilding a depleted skeleton. Advances must be made in determining the pathogenesis of osteoporosis with the goal of identifying those individuals at highest risk at a young age, when skeletal mass is still increasing. Intervention could then be aimed at maximizing the peak bone density through a combination of proper nutrition, exercise, and lifestyle changes. Clearly, there is much more to learn about this very common and debilitating disease.

Aged↗
PubMed1988

Overview of geriatric osteopenic syndromes. Part I: Definition and pathophysiology.

The clinical features of osteoporosis are identified, and their role in distinguishing this disease entity from osteomalacia, osteopenia, endocrinopathies, and marrow-packing disorders is discussed. An update is also offered on the ways in which calcium intake and estrogen levels are implicated in the pathophysiology of bone mass loss.

Aged↗